Regulatory Joe

What Health Plans Need to Know About the AV Calculator

In today’s episode of Regulatory Joe, we’re taking listeners through the 2025 Actuarial Value (AV) calculator, a tool that ensures plans meet standards for each metallic tier.
📌 Key Takeaways:
Consistent AV ranges for 2025 across all metallic tiers, with no major changes
Early testing with the draft AV calculator to stay on track with compliance
Best practices for version control and documentation when running the AV calculator
And more!
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How the 2024 Election Could Shape the Future of the Affordable Care Act

In this episode of Regulatory Joe, we break down the critical changes to Healthcare.gov that will reshape health plans in 2025. From streamlined enrollment to simplified plan selection, we dive into how these updates will impact issuers and plan operations in both federally facilitated and state-based marketplaces.
📌 Key Takeaways:
How the election results could reshape federal and state control over ACA marketplaces
The future of American Rescue Plan (ARP) insurance subsidies
What will happen with the newly released draft of the 2026 NBPP
And more!
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How Healthcare.gov 2025 Changes Will Impact Your Health Plan Strategy

In this episode of Regulatory Joe, we break down the critical changes to Healthcare.gov that will reshape health plans in 2025. From streamlined enrollment to simplified plan selection, we dive into how these updates will impact issuers and plan operations in both federally facilitated and state-based marketplaces.
📌 Key Takeaways:
Consistent user experience across Healthcare.gov and state exchanges
Simplified plan selection to reduce confusion for enrollees
Best practices for testing and syncing plan data
And more!
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2025 NBPP Changes Explained: Key Updates for Health Plans

In this episode of Regulatory Joe, we cover the critical changes coming in 2025 for the Notice of Benefit and Payment Parameters (NBPP).
Learn how telehealth, prescription drug access, re-enrollment rules, and network adequacy standards will shape health plans next year.
📌 Key Takeaways: Expanded telehealth documentation requirementsPrescription drug coverage updatesNew re-enrollment hierarchy rulesStricter network adequacy standards
🎧 Listen to the podcast version on Spotify, Apple Podcasts, or wherever you get your podcasts!
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What Do the New CMS EHB Benchmark Updates Mean for Your Health Plan?

In today’s episode of Regulatory Joe, we’re diving into an important topic that is shaping the future of health plan offerings: Essential Health Benefit (EHB) benchmark updates.
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How Routine Adult Dental Will Change Health Plans in 2025 and Beyond

In today's episode of Regulatory Joe, we cover a timely and impactful topic: the consideration of routine adult dental as an Essential Health Benefit (EHB) starting in 2025. This policy change by CMS poses significant implications for health plans and their members—let’s explore what this means and how health plans can prepare.
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Standard and Non-Standard Plan Options: What Your Health Plan Needs to Know

In today’s episode of Regulatory Joe, we’re discussing standard/non-standard plan options and potential changes on the horizon for 2025 and beyond.
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Network Adequacy and What Health Plans Need to Know for 2025

In today’s episode of Regulatory Joe, we’re diving into the important topic of network adequacy and significant changes that health plans need to be aware of for 2025 and beyond.
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Everything You Need to Know About State-Mandated Defrayal in 2025

In today’s episode of Regulatory Joe, we’re discussing state-mandated benefit defrayal and potential changes on the horizon for 2025 and beyond. Don't miss an episode! Hit subscribe or get email notifications by signing up at regulatoryjoe.co today.